Intraocular Lens Formula Comparison of Flanged Intrascleral Intraocular Lens Fixation with Double Needle Technique

Daniel S Malach,1 John Michael Guest,1 Christopher Adam,1 Jonah Joffe,2 Kim Le,2 Chaesik Kim,1 Xihui Lin1 1Kresge Eye Institute/Wayne State University Department of Ophthalmology, Detroit, MI, USA; 2Henry Ford Hospital Department of Ophthalmology, Detroit, MI, USACorrespondence: Xihui Lin, Kresge Eye Institute/Wayne State University Department of Ophthalmology, 4717 St. Antoine, Detroit, MI, 48201, USA, Email xihui.lin@wayne.eduPurpose: To analyze visual outcomes and accuracy of intraocular lens (IOL) calculation formulas in predicting postoperative outcomes in patients undergoing flanged intrascleral IOL fixation.Design: Case Series.Subjects: Twenty-three patients who had undergone secondary IOL placement using flanged intrascleral fixation technique.Methods: Retrospective chart review.Main Outcome Measures: Corrected distance visual acuity (CDVA) and postoperative spherical equivalent based on manifest refraction.Results: Visual acuity improved from 20/577 to 20/58. Overall, the actual refraction was 0.06 D more myopic than predicted. Holladay 2, Sanders Retzlaff Kraff/Theoretical (SRK/T) and Barrett Universal II resulted in mild myopic surprise (− 0.55, − 0.18 and − 0.20 D). Haigis and Hill-RBF (Radial Basis Function) resulted in mild hyperopic surprise (+0.28 and +0.28 D). Hoffer Q and Holladay 1 were the most accurate (− 0.02D and − 0.08 D).Conclusion: Flanged intrascleral IOL fixation improved vision even in patients with other posterior segment pathologies. The effective lens positioning is likely similar to in-the-bag positioning. Hoffer Q and Holladay 1 formulas with in-the-bag calculations were the most accurate.Keywords: aphakia, cataract, flanged technique, refractive, secondary intraocular lens